Individual
JACQUELINE MARIE O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1736 HAMILTON ST, ALLENTOWN, PA 18104
(610) 628-8300
Mailing address
581 E 10TH ST, NORTHAMPTON, PA 18067-1736
(610) 417-3175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA060028
STATE LICENSE
PA
Enumeration date
07/30/2018
Last updated
09/06/2018
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